From the Guidelines
The recommended dose of Citracal D3 for adults is 1200 mg of calcium and 800 to 1000 IU of vitamin D3 daily, as suggested by current expert opinion. This dosage is based on the recommendation that adults older than age 50 should take 1200 mg of calcium and 800 to 1000 IU of vitamin D daily, and the NCCN Bone Health in Cancer Care Task Force also recommends these ranges for younger patients at risk for cancer treatment–associated bone loss 1.
When considering the dosing of Citracal D3, it's essential to take into account the individual's serum 25(OH) D level, as this is the best indicator of vitamin D status. For patients with serum 25(OH) D levels below 30 ng/mL, a common regimen is prescription vitamin D (ergocalciferol) 50,000 IU weekly for 8 weeks, followed by a recheck of the serum 25(OH) D level, with subsequent dosing based on the results 1. However, for maintenance, a daily dose of 800 to 1000 IU of vitamin D3 is recommended.
It's also important to note that vitamin D3 could be more effective in raising 25(OH) D concentrations and maintaining those levels for a longer time when longer dosing intervals are employed, compared to vitamin D2 1. Additionally, a study published in the Annals of Internal Medicine found that fractures may be reduced for persons taking higher doses of vitamin D (≥800 IU daily) 1.
In terms of potential harms, the WHI trial reported an increased risk for nephrolithiasis with vitamin D and calcium supplementation, but the absolute risk was relatively low 1. Therefore, the benefits of taking Citracal D3 at the recommended dose of 1200 mg of calcium and 800 to 1000 IU of vitamin D3 daily likely outweigh the risks for most adults.
Some key points to consider when taking Citracal D3 include:
- Taking the supplement with food to enhance absorption
- Splitting the dose throughout the day, as the body can only absorb about 500-600 mg of calcium at once
- Starting with a lower dose and gradually increasing to the recommended amount if digestive issues occur
- Storing Citracal D3 at room temperature away from moisture and heat.
From the Research
Citracal D3 Dosing for Adults
The recommended dose of Citracal D3, which contains calcium and vitamin D3, can vary depending on several factors, including age and the presence of osteoporosis.
- For adults, especially those over 65 years of age, a daily dose of at least 1200 mg of calcium and 800 IU of vitamin D3 is suggested for the prevention and treatment of osteoporosis 2.
- It's also recommended that calcium intake be spread out throughout the day, with no more than 500 mg consumed at each meal to optimize absorption 3.
- Vitamin D intake of at least 600 IU per day, up to 1000 IU/day, is recommended for individuals older than 70 years, in addition to the calcium requirement of 1200 mg per day 3.
- Some studies suggest that higher doses of vitamin D3, ranging from 5000 to 50,000 IU/day, may be safe for long-term use in hospitalized patients, but this should be approached with caution and under medical supervision 4.
- For men and women 65 years of age or older, supplementation with 500 mg of calcium plus 700 IU of vitamin D3 per day has been shown to moderately reduce bone loss and the incidence of nonvertebral fractures 5.
Considerations for Supplementation
- Patients on bisphosphonate therapy for osteoporosis often do not recognize the need to supplement with calcium at the recommended dosage of at least 1200 mg/day, along with vitamin D 400 IU 6.
- The type of calcium supplement used can affect absorption, with calcium citrate being more soluble and potentially easier to absorb than calcium carbonate, especially in individuals taking proton-pump inhibitors 6.